A clinic in Niger uses an innovative and low-cost solution to keep babies alive

UNAIDS Executive Director Michel Sidibé visting the Issaka-Gazobi maternity clinic, which handles many complicated pregnancies and two years ago began providing services to pregnant women living with HIV. Niamey, Niger.

It is 10 am in the morning and the hot sun is already high in the sky above Niamey, Niger. Inside the Issaka-Gazobi maternity clinic a group of women are waiting expectantly for a meeting very few imagined they would ever have. The First Lady of Niger, Aïssata Issoufou Mahamadou and UNAIDS Executive Director, Michel Sidibé met the women during their visit recently to the maternity clinic, which is a model for the rest of the country.

The facility provided services to more than 20 000 patients and had nearly 6000 births last year. It handles many complicated pregnancies and two years ago began providing services to pregnant women living with HIV. The First Lady came to the clinic to officially donate food and medical supplies to the staff and she said, “This maternity is a model in the prevention of mother to child transmission services in Niger.”

Niger struggles with an extremely high infant mortality rate, which in 2012 the government estimated at 51 deaths per 1000 live births. Like many other maternity wards, Issaka-Gazobi struggles with providing quality care in a resource-poor setting. However, the big challenges facing the facility spurred the staff to become innovative and adapt a concept that has been used elsewhere to the local situation.

The maternity lacks enough incubators to keep alive all the premature babies in its care. So the staff developed a pouch, which can hold a new-born snug next to his or her mother’s body, benefitting from a natural human incubator. While, the so called “kangaroo care” concept has been used in a number of other countries, the Issaka-Gazobi is the first place to promote it in Niger. The device is novel in a country where most mothers carry their babies on their backs.

After seeing the innovative human incubator, Mr Sidibé said, “Kangaroo care is a wonderful concept. I am really impressed by how the maternity has adapted the idea to give life-saving warmth to premature babies and enable mothers to keep their infants alive.”

The Issaka-Gazobi provides antiretroviral therapy for free to mothers living with HIV to prevent transmission of the virus to their children and almost all patients living with HIV give birth to healthy babies. However in much of the country this is not the case. In 2011 Niger estimates less than 65% of pregnant women received an HIV test and less than 30% of pregnant women living with HIV had access to ARVs to prevent transmitting HIV to their children. The rate of HIV infection among children was nearly 22% in 2011.

Niger faces many challenges to preventing new HIV infections in children. While the majority of pregnant women receive a prenatal consultation, only around 30% of women give birth with the help of a trained health worker. This is primarily because while prenatal visits are free, receiving professional assistance at birth costs money. Many pregnant women, who test positive for HIV are lost to follow up and do not receive the treatment they need.

The government of Niger is striving to expand its services for preventing mother to child HIV transmission (PMTCT) and increased the funds it allocated to PMTCT from 2.6% of the total budget in 2010 to 15.9% in 2011. However, the country still faces a huge gap of around $US1.17 million this year for PMTCT services.

Mr Sidibé commended the country for the efforts it is making to improve health services for mothers and urged the country keep pushing towards stopping new HIV infections in children by 2015 and keeping their mothers healthy.